POS1357 THE 10-YEAR OUTCOME OF PATIENTS WITH BEHCET’S SYNDROME: A SINGLE-CENTER EXPERIENCE
Authors: A. Dogan, E. Tekgoz, S. Colak, M. Çinar, S. Yilmaz
Journal: Annals of the Rheumatic Diseases (2022)

Background Behcet’s syndrome (BS) is a vasculitis characterized by recurrent oral and genital ulcers, as well as ocular, cutaneous, vascular, gastrointestinal, musculoskeletal, and central nervous system manifestations. Objectives The study aimed to evaluate the 10-year outcome of patients with BS. Methods A cohort of 682 patients diagnosed with BS between January 2007 and December 2009 in the rheumatology outpatient clinic of Gulhane Training and Research Hospital were re-evaluated in November 2021. The data regarding the clinical course of 84 patients (84/682) were obtained from patients’ files and detailed telephone interviews. Results The study included 84 patients (63 male, 21 female) with a mean age of 47.1±10.6 years. The mean disease duration was 17.6±5.7 years. At the time of the diagnosis, the mean age of the patients was 29.5±9.4 years. Oral ulcer (100%), papulopustular lesions (82.1%), genital ulcer (77.4%), and erythema nodosum (59.5%) were the most frequent manifestations at the time of diagnosis. Ocular (46.4%), musculoskeletal (35.7%), vascular (19%), gastrointestinal (3.6%), and neurological (1.2%) manifestations were seen in decreasing frequency. The most frequent ocular disease was posterior uveitis, whereas superficial thrombophlebitis and deep venous thrombosis were the most prevalent forms of vascular involvement. One patient had transverse myelitis as neurological involvement. Colchicine (88.1%) and corticosteroids (57.1%) were the most preferred drugs for the initial treatment. Fifty-one (60.7%) patients received at least one immunosuppressive agent. After 10-year, there was a statistically significant decrease in all manifestations of BS (Table 1). Nevertheless, 9 (10.7%) patients (8 male, 1 female) had new clinical findings. Five patients had (5.9%) mucocutaneous, 2 (2.4 %) arthritis and 2 (2.4%) vascular lesions as new clinical manifestations. The mean age of the patients with newly onset clinical findings was 48±8.9 years. There was no statistically significant difference between patients with and without new clinical findings with respect to age (p=0.79). The new onset mucocutaneous manifestations were genital ulcer and erythema nodosum. Besides, new onset vascular lesions were superficial and deep venous thrombosis of the lower extremities. The mean age of the patients who developed venous thrombosis at the time of the assessment was 37.0±7.07 years. Vascular involvement was detected more frequently in younger patients (p=0.03). However, ocular involvement is a frequent symptom after mucocutaneous involvement at the beginning, none of the patients had new eye involvement at the end of the follow-up. Colchicine, corticosteroid, and azathioprine were associated with the highest drug survival. Twenty-one (41.1%) patients of who were administered immunosuppressive agents as initial therapy were still using immunosuppressives 10 year later. The most frequently prescribed immunosuppressives were azathioprine and cyclosporine during the follow-up. Table 1. Clinical manifestations of Behcet’s syndrome Initial After 10 years p No Yes Oral ulceration, n (%) No 0 0 0 &lt;0.001* Yes 84 (100) 42 (50) 42 (50) Genital ulceration, n (%) No 19 (22.7) 16 (84.2) 3 (15.8) &lt;0.001** Yes 65 (77.4) 54 (83.1) 11 (16.9) Erythema nodosum and Papulopustular lesions, n (%) No 6 (7.1) 4 (66.7) 2 (33.3) &lt;0.001** Yes 78 (92.9) 44 (56.4) 34 (43.6) Arthritis, n (%) No 54 (64.3) 52 (96.3) 2 (3.7) &lt;0.001** Yes 30 (35.7) 21 (70) 9 (30) Vascular involvement, n (%) No 68 (81) 66 (97.1) 2 (2.9) 0.013** Yes 16 (19) 12 (75) 4 (25) Gastrointestinal involvement, n (%) No 81 (96.4) 81 (100) 0 &lt;0.001* Yes 3 (3.6) 3 (100) 0 Ocular involvement, n (%) No 45 (53.6) 45 (100) 0 &lt;0.001** Yes 39 (46.4) 29 (74.4) 10 (25.6) Neurological involvement, n (%) No 83 (98.8) 83 (100) 0 &lt;0.001* Yes 1 (1.2) 1 (100) 0 *McNemar-Bowker Test, **McNemar Test Conclusion The frequency of newly onset clinical manifestations decreases with age in BS, especially after age 40. Besides, especially male Behcet’s patients should be followed-up regularly for complications that may develop regardless of age. Disclosure of Interests None declared